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Preregister form - Mention Brut Photography

Treats for Troops/Operation Pocket Change Benefit Show

Sunday, February 26th, 2012 · 11:00am - 3:00pm
Quaker Steak and Lube
10400 49th Street
Clearwater, Florida

Name______________________________________________ ______Date___________
Address_____________________________________
Email (optional)_______________________
Phone___________ Cell_______________ Vehicle__________________
Check #_____________Amount_____________
Club Affiliation____________________________
Cornhole Tournament $5.00 a person ___________ Team Name:______________
Show is Sunday February 26th, 2012
$10.00 pre-registrations; $15.00 day of show with judging and limited to 300 entries.
* Show parking 10:00am-11:00pm, Quaker Steak and Lube 10400 49th Street Clearwater, Florida.
* No alcohol will be allowed at this event.
** Please make checks payable to Cianfrocca’s Auto Detailing LLC/Tampa Jax Wax and mail with registration to: Tampa Jax Wax
10631 Deepbrook Drive
Riverview, FL 33569
I, ________________________________________(participa nt), acknowledge that I have voluntarily applied to participate in the Treats for Troops Benefit Car Show at Quaker Steak and Lube on February 26th, 2012. As consideration for being permitted by the Show, the Property Owners and any Sponsor of the show premises to participate in these activities and use the Show premises and facilities, I forever release the Show, the property, the Sponsors, and any Show affiliated organization, and their respective directors, officers, employees, volunteers, agents, contractors and representatives (collectively releases) from any and all actions, claims or demands that I, my assignees, heirs, distributees, guardian, next of kin, spouse and legal representative now have, or may have in the future, for injury, death, or property damage related to 1) my participation in these activities 2) the negligence or other acts, whether directly connected to these activities or not, and however cause, by and Release, or 3) the condition of the premises where the activities occur, whether or not I am then participating in the activities. I also agree that I, my assignees, heirs, distributees, guardians, next of kin, spouse and legal representatives will not make a claim against, sue or attach the property of any Releasee in connection with any of the matters covered by the foregoing release.
I have carefully read this agreement and fully understand its contents. I am aware that this is a release of liability and a contract between myself and the Show, the property and the Sponsors, and sign it of my own free will.

Participant / Releasor (print)_________________________(sign)____________ ________
_________________________, 2011


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